TRADEMARK QUESTIONNAIRE

S.No. Details Required Please write the details

1. Trademark Owner Name Ms. Shalu Singh

(Write the name of Company or Firm or Individual, in

whose name the trademark to be registered)
2. Type of Organisation/Owner Proprietorship Firm
(Write whether Pvt. Ltd./Public Ltd./LLP/ Partnership
Firm/Proprietorship Firm/Trust/Individual)

3. Address of the Trademark Owner Flat no. 21128, Tower-9, Mahagun

Mywoods, Opposite Gaur city -2, Noida

Extension-201309, UP

4. Full name of all the Partners/Directors NA

/Trustees
(Not required in case of Individual or Proprietorship
applicants)
5. Full name of the person who will sign Ms. Shalu Singh
Authorization Letter
(i.e. on behalf of company/LLP/firm/trust)
6. Residence address, Age, Nationality,Mobile No. Address:- Flat no. 21128, Tower-9, Mahagun
& Email Id of the Signatory Mywoods, Opposite Gaur city -2, Noida Extension-

201309, UP

Age- 30 Yrs

Nationality:- Indian

Mobile No. 9760442193

Email id:- 2089shalu@gmail.com

7. Brand Name for Trademark Myra Clothings

8. LOGO of the Trademark PASTE your LOGO here (only if available)
 Trademark can be applied even without a LOGO.
If not available leave it blank.
 You can also send the LOGO separately in an
email attachment

9. Logo/Image Explanation:Explain in 2- 3 lines the

image or style or figure or design of logo (Required if
the brand name consists a logo)

Eg: “The trademark consist of the alphabet ‘S’

with sharp ends pointing towards upward direction applied
over the background of circle”
10. Trade descriptionof Goods/Services Women Ethnic wears Like Kurtis, PLazzo
(Please write exact goods or services sold / promoted
under this brand name, in 3-4 lines. Include only specific Sets, Dresses, Duppttas, Bottoms
goods or services name)
Eg: Software Development:Software development and IT
enabled services.

11. Whether Small Business or Large Enterprise

(Not applicable to Individual Applicants)

Large Enterprise means

For MANUFACTURING INDUSTRY: If the investment in
Plant & Machinery is more than Rs. 10 crore
For SERVICE INDUSTRY: If investment in office equipment
is more than Rs. 5 crore
12. Write whether the applicant is Selling/Trading Amazon, Limeroad,
products on any online portal
www.myraclothings.com
(like Amazon / Flipkart / Snapdeal, etc.)
13. User Date of the Brand/Mark A
Please select any one option:
a) Proposed to be used/to be used in future
b) Already in use (If already in use write the date
 since when brand is in use)Please refer to the
below Important Note regarding user affidavit.

14. Service Address Flat no. 21128, Tower-9, Mahagun

(Please write the address where you want the
Trademark registry to communicate with you) Mywoods, Opposite Gaur city -2, Noida

Extension-201309, UP

15. GSTIN Number of the Applicant 09EOFPS3872R2ZR

(This is needed to prepare the TAX Receipt after
completion of the work OR mention NA (if not
applicable or you don't have a GST number)

Important Note:

A) In case if the brand name is already in use, it is mandatory to give a notarized “User Affidavit” on stamp paper of
Rs.100 by the applicant (format for the same shall be provided by Startupwala).

B) If you are selling products on Amazon, they only accept “Wordmark”. If your brand name contains logo, you
may need to apply two trademark applications one with the logo (Device mark) and another application
without logo (Wordmark).
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